The Trump Administration announced a new initiative on Wednesday designed to allow Americans to share their medical records across a host of apps and programs managed by private tech companies—a move that proponents says will facilitate easier access to those records across the country’s fragmented health care system, but that digital privacy experts fear will risk making patients’ data less secure.[time-brightcove not-tgx=”true”]“For decades, America’s health care networks have been overdue for a high-tech upgrade and that’s what we are doing,” President Donald Trump said during an event announcing the initiative on Wednesday afternoon.The Administration “secured commitments” from more than 60 tech and health care companies—including Amazon, Apple, Google, and OpenAI—“to begin laying the foundation for a next-generation digital health ecosystem that will improve patient outcomes, reduce provider burden, and drive value,” according to a press release from the U.S. Centers for Medicare & Medicaid Services (CMS).Making health records more easily accessible has been a goal of the federal government for decades, with the hope of allowing patients to seamlessly switch between providers. But such efforts have long been dogged by concerns over privacy and the challenges of companies offering competing proprietary records systems. The Administration’s new initiative, according to CMS, will focus on “easily and seamlessly” sharing information between patients and medical providers, as well as “increasing the availability of personalized tools so that patients have the information and resources they need to make better health decisions.” Initial goals of the initiative include apps that focus on diabetes and obesity management, using conversational AI assistants to help patients, and replacing paper intake forms with digital check-in options.The announcement was the latest move by the Trump Administration to emphasize the value of incorporating the latest technology in the health system. In June, Health and Human Services Secretary Robert F. Kennedy Jr. testified in a congressional hearing about how he sees “wearables” like smart watches as a game changer in health care.“We think that wearables are a key to the MAHA agenda—Making America Healthy Again. My vision is that every American is wearing a wearable within four years,” Kennedy said.The announcement prompted immediate pushback from digital privacy experts, who warned of the dangers of sharing health data with companies that aren’t covered by the Health Insurance Portability and Accountability Act, or HIPAA, the federal law that protects personal health information from being shared by certain entities, such as medical providers and insurers, without a person’s consent.Andrew Crawford, a senior policy counsel at the Center for Democracy and Technology, says he has concerns about how the data will be collected and used by the companies involved in the initiative, what consumers will be told about their data privacy, and what limits there will be on how the data can be used and shared. If the company were to share a patient’s information that went beyond the requested health service—like with advertisers that could then potentially target that individual based on inferences from their health data—that would be problematic, Crawford says.Another unanswered question, he says, is in what circumstances, if any, the government would be able to access patients’ health data through this initiative, and, if so, how they may or may not use that information.“We’ve seen recently this Administration creating data sets that didn’t exist before and using them for things like immigration enforcement,” Crawford says. He points to reproductive health choices as an example of medical data that many would be uncomfortable being shared across so many companies. Many apps also collect location data, Crawford notes, so he worries about the possibility that the data collected could show, for instance, if people traveled out of state to access abortion care that isn’t legal in their home state.CMS said in its announcement that the initiative will be “more secure, and more personalized,” and “use secure digital identity credentials to obtain medical records from CMS Aligned Networks.”Dr. Brian Anderson, chief executive officer of the Coalition for Health AI, a nonprofit focused on creating guidelines for the responsible use of AI in health care, agrees there are “some outstanding questions” about the initiative, including what protections will be in place to ensure that the data shared with tech companies not covered by HIPAA will remain private. But he believes this is a challenge that can be addressed.“We just need to come together, as both private sector and public sector, and clearly define what those rules of the road are to ensure that patients’ data is used in ways only that they intend and want it to be used,” Anderson says.He says that he is “very excited” to see a group of tech companies pledging to “to make it easier for patients to have access to their own data,” especially since “our data is oftentimes not in one centralized place.”Still, others were unsure that this initiative would produce much benefit for patients, particularly if their sensitive medical records end up compromised.“I think our system is designed to promote sharing already,” Crawford says. “There are issues and there are hang-ups and flaws in that system, but I’m not sure—because I haven’t seen the details yet—on if and how this announcement that’s sharing more information with private entities, many of which may be outside HIPAA, will do anything to increase the quality of care.”